Best Lyle G, Lunday Laramie, Webster Elisha, Falcon Gilbert R, Beal James R
a Turtle Mountain Community College , Natural Science Department , Belcourt , North Dakota , USA.
b University of North Dakota, School of Medicine , Family and Community Medicine Department , Grand Forks , North Dakota , USA.
Hypertens Pregnancy. 2017 May;36(2):131-137. doi: 10.1080/10641955.2016.1250905. Epub 2016 Dec 21.
Pre-eclampsia (PE) shares a number of proposed pathophysiologic mechanisms related to those implicated in cardiovascular disease (CVD), such as endothelial dysfunction, inflammation, insulin resistance, and impaired renal regulation. PE has also been associated with subsequent hypertension, CVD, and related mortality in later life.
At follow-up, the four most recent blood pressures, body mass index (BMI), and use of hypertensive medications were recorded from clinic visits of 130 PE cases and 289 normal pregnancies. Student's t test, Chi-square testing, multivariate linear, and logistic regression were used in analysis.
Follow-up measurements occurred a mean of 13.11 years post PE pregnancy. Multivariate linear regression showed a significant and independent association between current systolic blood pressure and previous history of PE (β = 4.47, p = 0.04), while adjusting for age, BMI, and blood pressure from 1 year prior to and up to the 20th week of gestation. A similarly adjusted multivariate logistic regression model found an odds ratio of 3.43, 95% CI 1.83-6.43, p = 0.001 for subsequent hypertension. Logistic regression analysis of the quartile with follow-up of less than 7.19 years also shows independent association of prior PE with subsequent hypertension.
PE appears to confer risk of subsequent hypertension on this cohort of American Indian women within as little as 8 years. This risk is independent of additional risk factors such as increased age, BMI, and blood pressure prior to 20 weeks of gestation. There is evidence of increased risk among those with more severe PE.
子痫前期（PE）与心血管疾病（CVD）存在一些共同的病理生理机制，如内皮功能障碍、炎症、胰岛素抵抗和肾脏调节受损。子痫前期还与随后发生的高血压、心血管疾病及晚年相关死亡率有关。
在随访中，记录了130例子痫前期病例和289例正常妊娠者门诊时最近的四次血压、体重指数（BMI）以及高血压药物使用情况。分析采用学生t检验、卡方检验、多元线性回归和逻辑回归。
子痫前期妊娠后平均13.11年进行随访测量。多元线性回归显示，在校正年龄、BMI以及妊娠前1年至妊娠20周的血压后，当前收缩压与既往子痫前期病史之间存在显著且独立的关联（β = 4.47，p = 0.04）。类似校正后的多元逻辑回归模型发现，后续发生高血压的比值比为3.43，95%置信区间为1.83 - 6.43，p = 0.001。对随访时间少于7.19年的四分位数进行逻辑回归分析也显示，既往子痫前期与后续高血压存在独立关联。
子痫前期似乎在短短8年内就使这群美国印第安女性面临后续高血压的风险。这种风险独立于其他风险因素，如年龄增加、BMI以及妊娠20周前的血压。有证据表明，子痫前期病情越严重，风险越高。
